Cardiac Rehabilitation Exercise Research Articles

Therapeutic Effect of Cardiac Exercise Rehabilitation Program Based on Cardiopulmonary Exercise Test on Patients with Stable Coronary Heart Disease Complicated with Hypertension

Therapeutic Effect of Cardiac Exercise Rehabilitation Program Based on Cardiopulmonary Exercise Test on Patients with Stable Coronary Heart Disease Complicated with Hypertension

'The illness isn't the end of the road'-Patient perspectives on the initiation of and early participation in a multi-disease, community-based exercise programme.

Exercise is the cornerstone of cardiac rehabilitation (CR). Hospital-based CR exercise programmes are a routine part of clinical care and are typically 6-12 weeks in duration. Following completion, physical activity levels of patients decline. Multi-disease, community-based exercise programmes (MCEP) are an efficient model that could play an important role in the long-term maintenance of positive health behaviours in individuals with cardiovascular disease (CVD) following their medically supervised programme. To explore patients experiences of the initiation and early participation in a MCEP programme and the dimensions that facilitate and hinder physical activity engagement. Individuals with established CVD who had completed hospital-based CR were referred to a MCEP. The programme consisted of twice weekly group exercise classes supervised by clinical exercise professionals. Those that completed (n = 31) an initial 10 weeks of the programme were invited to attend a focus group to discuss their experience. Focus groups were transcribed and analysed using reflexive thematic analysis. Twenty-four (63% male, 65.5±6.12yrs) patients attended one of four focus groups. The main themes identified were 'Moving from fear to confidence', 'Drivers of engagement,' and 'Challenges to keeping it (exercise) up'. Participation in a MCEP by individuals with CVD could be viewed as a double-edged sword. Whilst the programme clearly provided an important transition from the clinical to the community setting, there were signs it may breed dependency and not effectively promote independent exercise. Another novel finding was the use of social comparison that provided favourable valuations of performance and increased exercise confidence.

Effects of different rehabilitation modality on cardiopulmonary function in patients with acute coronary syndrome after revascularization.

To investigate the effects of different rehabilitation modalities on cardiopulmonary function in patients with acute coronary syndrome after revascularization. Two randomized controlled trials were conducted. All patients were stable for more than 48 h and less than 1 week after revascularization for acute coronary syndrome and were randomly assigned to Group A (home-based rehabilitation group) or Group B (center guided home-based rehabilitation group). The cardiopulmonary exercise test was mainly performed before and 3 months after cardiac rehabilitation (at the end of intervention). The primary endpoints of the study were peak oxygen uptake (VO2peak), and the secondary endpoints were maximum metabolic equivalents (METs), anaerobic threshold exercise load (Load AT), maximal workload (Load max), and anaerobic threshold oxygen uptake (VO2 AT). A total of 106 patients were included in the study, with 47 patients in Group A (with 6 losses) and 50 patients in Group B (with 3 losses). There were no significant difference between the two groups in terms of age, gender, body mass index (BMI), left ventricular ejection fraction(LVEF), low-density lipoprotein cholesterol(LDL-C),cardiovascular risk factors. In Group A, no significant differences in CPET indices were observed before and after the intervention. In Group B, values of maximum metabolic equivalents (METs), peak heart rate (PHR), anaerobic threshold exercise load (Load AT), maximal workload (Load max), maximum ventilation per minute (VE max), peak oxygen uptake (VO2peak), anaerobic threshold oxygen uptake (VO2 AT) and maximum oxygen pulse (VO2/HRmax) were higher than those before the intervention (P < 0.05). In addition, METs (max), Load AT, Load max, VO2 AT, and VO2peak in Group B were higher than those in group A (P < 0.05). The change rates of VO2peak, METs(max), PHR, Load max, VO2 AT, VE max, VO2/HR(max) in the two groups were significantly different before and after intervention (P < 0.05). Cardiac exercise rehabilitation is helpful for improving patients' cardiopulmonary endurance and quality of life. Moreover, rehabilitation modalities with regular hospital guidance can improve cardiopulmonary function in a shorter period,which seems to be more effective than a complete home-based rehabilitation model. http://www.chictr.org.cn, identifier (ChiCTR2400081034).

Editorial comments: focus on exercise in sport cardiology and cardiac rehabilitation.

Editorial comments: focus on exercise in sport cardiology and cardiac rehabilitation.

The role of exercise-based cardiac rehabilitation after percutaneous coronary intervention in patients with coronary artery disease: a meta-analysis of randomised controlled trials

Background this study was designed to analyse patient outcomes using a combination of PCI and exercise-based cardiac rehabilitation compared with PCI alone. Methods PCI can improve the survival rate of patients with coronary artery disease, but it can also cause vascular endothelial cell injury, thrombosis, and even restenosis. Early cardiac rehabilitation exercise is crucial for patients with coronary heart disease after PCI. Five databases were examined for randomised controlled trials involving early cardiac rehabilitation exercise and standard treatment in patients with coronary heart disease after PCI. The search period lasted from the creation of the database (2006) until December 2022. The outcomes including angina, arrhythmia, coronary restenosis, left ventricular ejection fraction, left ventricular end diastolic diameter, 6-min walk distance, total cholesterol, heart rate, systolic blood pressure and diastolic blood pressure. RevMan 5.3 was used to analyse the data, and the Cochrane Collaboration was used to assess the quality of evidence. Results A total of 1231 patients were enrolled in this study. Angina pectoris (RR = 0.24, 95% CI [0.10, 0.57], p = 0.001), Arrhythmia (RR = 0.17, 95% CI [0.05, 0.55], p = 0.003), Coronary artery restenosis (RR = 0.10, 95% CI [0.01, 0.76], p = 0.03). Conclusion Exercise after PCI improves LVEF, enhances 6MWD, lowers HR and minimises the risk of angina, arrhythmia and coronary artery restenosis in CHD patients. Exercise had no discernible effect on LVEDD, TC, SBP, or DBP.

Comparing domain- and intensity-specific physical activity in coronary heart disease and non-CHD individuals

Although increase in physical activity is important to improve prognosis of cardiac patients in addition to hospital-based exercise cardiac rehabilitation, their physical activity levels are not properly understood. This study aimed to examine domain- and intensity-specific physical activity in individuals with coronary heart disease (CHD) and compare them with non-CHD individuals. Data from the Korean National Health and Nutrition Examination Survey (KNHANES) from 2014 to 2019 were analyzed, including 1083 CHD patients and 38,532 non-CHD individuals. The inclusion criteria were age 19 years or older and data not missing for CHD information. Before and after propensity score matching (PSM) for age, sex, body mass index, education, household income, alcohol intake, and smoking status, domain (leisure, work, transportation)—and intensity (moderate, vigorous) -specific physical activity participation levels were compared between individuals with and without CHD. Before PSM, CHD individuals were older, less educated, more sedentary, and participated less in PAs compared to non-CHD individuals. After PSM, CHD individuals had similar levels of domain-specific PAs. However, they had higher work-related PA levels (29.7 ± 209.6 vs. 42.1 ± 291.3 min/week p = 0.022) and more sedentary time (487.2 ± 224.2 vs. 514.1 ± 228.7. p = 0.003) than those without CHD. Subgroup analysis revealed lower leisure-related PA in men with CHD (63.5 ± 165.5 vs. 47.3 ± 140.2, p < 0.05) and higher work-related PA in women with CHD (18.9 ± 159.7 vs. 57.1 ± 397.5, p < 0.01). Among those < 65 years of age, individuals with CHD spent more time sedentary than individuals without CHD. CHD individuals are not physically inactive compared with non-CHD individuals who are similar in sociodemographic status and lifestyle. CHD patients’ PA levels may have been underestimated.

Analysis of Prescription Compliance and Influencing Factors in Cardiac Rehabilitation after Surgery in Children with Congenital Heart Disease Based on Generalized Trust Theory.

To understand the compliance, influencing factors, and action path of family cardiac rehabilitation exercise prescriptions for children after congenital heart disease surgery. A random sampling method was used to select 200 pediatric patients and their parents from a pediatric hospital in Shanghai. Among them, 57 cases (28.5%) of children's families followed the cardiac rehabilitation exercise prescription. Path analysis showed that peak oxygen uptake exerted a negative impact on the compliance of family cardiac-rehabilitation prescriptions for patients after congenital heart disease surgery through doctor-patient trust, with a standardized path coefficient of -0.246 (P = 0.001). Disease-related knowledge exerted a positive effect on the compliance of family cardiac-rehabilitation prescriptions for children after congenital heart surgery through doctor-patient trust, with a standardized path coefficient of 0.353 (P < 0.001). The dimension of friend support in social support had a direct positive effect on the compliance of family cardiac-rehabilitation prescriptions for children after cardiac surgery, with a standardized path coefficient of 0.641 (P = 0.006). The compliance of cardiac rehabilitation exercise prescription in children with congenital heart disease is not good and is affected by many factors, and there is a complex path relationship between various factors; the kilogram oxygen consumption of the child, the disease-related knowledge of the caregiver, and social support all play important roles in the compliance of the child's family's health prescription. SCMCIRB-K2021002-1.

"Challenges to Normalcy"- Perceived Barriers to Adherence to Home-Based Cardiac Rehabilitation Exercise in Patients with Chronic Heart Failure.

The aim of this study was to explore perceived barriers to adherence to home-based cardiac rehabilitation exercise in patients with chronic heart failure. A qualitative descriptive study was conducted in this study from May to July 2023. A purposive sampling approach was adopted to select patients with chronic heart failure. Semi-structured interviews were completed to collect qualitative data for exploring the perceived barriers. In addition, information saturation and validation strategies were adopted to prove the adequacy of qualitative data. Transcripts were analysed using thematic analysis. A total of 16 patients with chronic heart failure were included in this study. Analysis of the data revealed five main barriers to adherence to home-based cardiac rehabilitation in patients with chronic heart failure. These include (1) lack of knowledge, (2) activity intolerance, (3) exercise fear, (4) role conflict, and (5) lower exercise self-efficacy. This study delved deeper into understanding the challenges faced by chronic heart failure patients in adhering to home-based cardiac rehabilitation exercise. The development of precise and effective management and intervention strategies based on these barriers is necessary to improve patient compliance with home-based cardiac rehabilitation exercise.

The effects of cardiovascular rehabilitation in patients with heart failure with reduced ejection fraction - does gender really matter?

Abstract Background The prevalence of heart failure (HF) in the adult population appears to be 1-2%, and it rises with age. About ½ of HF patients have reduced ejection fraction (HFrEF). Although the positive effects of cardiac rehabilitation (CR) in patients with HFrEF are well known, women seem to participate in CR significantly less compared to men. Purpose To determine whether there is a difference in the effects of CR on the tolerance of physical strain and the quality of life (QOL) related to gender in examinees with HFrEF. Methods The study involved 225 pts with HFrEF, 190 men (84.4%) and 35 women (15.56%), who were referred to a three-week CR program. At baseline and the end of CR exercise stress test (EST) was taken. The QOL was assessed at the beginning and the end of CR by validated questionnaire Short-Form 36. Results Male pts showed better strain tolerance on the first and the second EST compared to female pts. However, both gender showed improvement in physical strain tolerance on the second EST by achieving higher strain level (men 2.17±0.85 vs. 2.56±0.88, p=0.000; women 1.74±0.7 vs. 2.14±0.77, p=0.001), and longer duration of EST (men 2.56±2.97 vs. 5.64±2.85, p=0.000; women 2.28±2.46 vs. 4.63±2.4, p=0.000). Also, significantly more male and female pts achieved submaximal heart rate on the second EST (p=0.000 for men, and p=0.046 for women). Furthermore, CR has led to an improvement in the QOL in both men and women. Namely, all parameters were better at the end of CR, both in men and women. However, statistically significant improvements in female pts were noted in physical functioning (40±16.96 vs. 70±6.12, p=0.034), and energy/fatigue (43±17.54 vs. 62±20.49, p=0.041). On the other hand, the statistical significance in male pts was reached in physical functioning (59.38±25.57 vs. 67.23±23.47, p=0.002), energy/fatigue (60.43±22.7 vs. 64.08±21.22, p=0.036), emotional well-being (71.31±20.97, vs. 74.29±21.18, p=0.011), body pain (63.64±26.95 vs. 71.93±23.58, p=0.000), and general health (48.94±14.7 vs. 55.27±18.1, p=0.000). Conclusion Women generally less participate in CR than men. Results indicated that CR improves exercise capacity and QOL in HFrEF patients, in both men and women. This is why CR needs improvement in the referral and participation of women.

Abstract 12755: Increased Physical Activity and Higher Perceived Social Support Are Associated With Improved Quality of Life in Patients With Heart Disease Reporting Hopelessness

Introduction: Hopelessness has been identified in up to 52% of patients with ischemic heart disease (IHD). Hopelessness is associated with both decreased self-reported physical activity (PA) and lower perceived social support. Quality of life (QOL) is positively associated with PA and perceived social support in patients with IHD. However, the relationships among PA, perceived social support, and QOL in patients with IHD reporting hopelessness has not been explored. Purpose: To examine the associations among PA, perceived social support, and QOL in patients with IHD reporting hopelessness. Hypotheses: 1) Higher PA and increased perceived social support are each separately associated with higher QOL. 2) PA mediates the relationship between perceived social support and QOL. Methods: Data were collected two weeks after hospital discharge from patients with moderate to severe hopelessness using the State-Trait Hopelessness Scale. Perceived social support, PA, and QOL were measured using the ENRICHED Social Support Inventory, Cardiac Rehabilitation Exercise Participation Tool, and EQ-5D-5L, respectively. Linear regression was performed to assess the associations among study variables, controlling for age, gender, marital status, and employment. Results: The majority of participants (n = 154) were male (68.2%) and non-Hispanic white (90.9%) with a mean age of 62 years (SD = 9.68). Approximately half of participants were married (53.9%) and not working (55.2%). Higher perceived social support and higher PA were each separately associated with higher QOL after adjusting for demographic variables (perceived social support: r partial = 0.23, p = 0.011; PA: r partial = 0.23, p = 0.007). PA partially (21.30%) (r partial = 0.181, p = 0.040) mediated the relationship between perceived social support and QOL (r partial = 0.172, p = 0.066), suggesting that increasing perceived social support may improve PA, thus improving patients’ QOL. Conclusions: Our hypotheses of positive association among PA, perceived social support, and QOL were confirmed. Further research in larger, more heterogeneous samples is needed to examine potential causal relationships among PA, perceived social support and QOL in patients with IHD who report hopelessness.

Predictors of home-based cardiac rehabilitation exercise adherence among patients with chronic heart failure: a theory-driven cross-sectional study

BackgroundThe factors influencing home-based cardiac rehabilitation exercise adherence among patients with chronic heart failure remain unclear. This study aimed to explore predictors of home-based cardiac rehabilitation exercise adherence in these patients, based on the theory of planned behavior.MethodsThis theory-driven, cross-sectional study used convenience sampling to recruit patients with chronic heart failure undergoing home-based cardiac rehabilitation. Instruments used included the Home-Based Cardiac Rehabilitation Exercise Adherence Scale, the Multidimensional Self-Efficacy for Exercise Scale, the Perceived Social Support Scale, and the Tampa Scale for Kinesiophobia Heart. Multivariate linear hierarchical regression analysis was employed to examine the factors influencing exercise adherence.ResultsA total of 215 patients with chronic heart failure undergoing home-based cardiac rehabilitation participated in the study. The overall score for home cardiac rehabilitation exercise adherence was (48.73 ± 3.92). Multivariate linear hierarchical regression analysis revealed that age (β=-0.087, p = 0.012), education level (β = 0.080, p = 0.020), fear of movement (β=-0.254, p < 0.001), perceived social support (β = 0.451, p < 0.001), and exercise self-efficacy (β = 0.289, p < 0.001) influenced home-based cardiac rehabilitation exercise adherence. In the second model, fear of exercise explained 23.60% of the total variance, while perceived social support and exercise self-efficacy explained 26.60% of the total variance in the third model.ConclusionThis study found that home-based cardiac rehabilitation exercise adherence in patients with chronic heart failure was suboptimal, and identified its influencing factors. Targeted interventions addressing these factors, such as tailored education, support, and addressing fear of exercise, may help improve exercise adherence.

Relationship Between Number of Cardiac Rehabilitation Exercise Training Sessions, Muscle Mass, and Cardiorespiratory Fitness in Rural Elderly Patients with Coronary Artery Disease [Letter

Relationship Between Number of Cardiac Rehabilitation Exercise Training Sessions, Muscle Mass, and Cardiorespiratory Fitness in Rural Elderly Patients with Coronary Artery Disease [Letter

Relationship Between Number of Cardiac Rehabilitation Exercise Training Sessions, Muscle Mass, and Cardiorespiratory Fitness in Rural Elderly Patients with Coronary Artery Disease.

This study aimed to compare the effects of a cardiac rehabilitation (CR) exercise program on skeletal muscle index (SMI) and cardiorespiratory fitness (CRF) in patients aged ≥65 years. From January 2012 to December 2021, patients living in rural regions aged ≥65 who underwent percutaneous coronary intervention for acute myocardial infarction (AMI) and at least one CR exercise session were enrolled. We retrospectively reviewed the medical records of the patients who underwent an exercise tolerance test (ETT) at initial and 3-month follow-ups. A total of 36 patients were enrolled who underwent a mean of 6.56 exercise sessions and were divided into groups based on the number of center-based CR (CBCR) sessions: 14 in Group A (≥7 sessions) and 22 in Group B (<7 sessions). In CBCR session, we comprehensively counseled them about their nutrition, smoking cessation et al. Both groups underwent an ETT after 12 weeks. The outcomes were CRF parameters examined by a cardiorespiratory exercise test and the SMI examined by bioimpedance analysis (BIA). The number of exercise sessions was significantly correlated with the rate of SMI change. Group A showed significant increases in metabolic equivalent of task (MET), maximal oxygen uptake (VO2max), and SMI after 3 months. There were significant differences in the rates of change in MET, VO2max, and SMI between the two groups. CRF significantly improved in Group A in a short period. Further studies are required to increase long-term CBCR adherence in elderly patients with AMI in rural regions.

A behavioural driving model of adherence to home-based cardiac rehabilitation exercise among patients with chronic heart failure: A mixed-methods study.

To develop and validate a behavioural driving model for adherence to home-based cardiac rehabilitation exercise in patients with chronic heart failure, and to explain the potential driving mechanism of social support on exercise adherence. Despite the benefits of home-based cardiac rehabilitation exercise, adherence among patients with chronic heart failure remains suboptimal. Several factors contributing to adherence have been confirmed; however, the specific pathway mechanisms by which these factors impact exercise adherence have not been thoroughly explored. An exploratory sequential mixed-methods study was conducted in this study. A total of 226 patients with chronic heart failure were recruited using convenience sampling. Quantitative data were collected using a series of self-report questionnaires. Hierarchical regression analysis was performed to verify multiple pathways. Subsequently, 12 patients with chronic heart failure were drawn from the quantitative stage. The interview data were thematically analysed. This study followed the Good Reporting of a Mixed Methods Study (GRAMMS) guidelines (Appendix S1). Perceived social support had a direct positive predictive effect on exercise adherence. Importantly, exercise self-efficacy and exercise fear played a chain-mediating role between perceived social support and exercise adherence. As a result of the qualitative phase, scale, tightness and homogeneity of social support networks emerged as potential drivers of the effectiveness of social support on exercise adherence. This study reveals a potential pathway mechanism for social support to improve adherence to home-based cardiac rehabilitation exercises. Social support network plays a crucial role in the effect of social support on exercise adherence. To enhance exercise adherence in home-based cardiac rehabilitation for patients with chronic heart failure, establishing a social support network is recommended. This strategy has the potential to promote exercise self-efficacy and alleviate exercise fear. None.

Exercise for cardiac rehabilitation in a warming climate.

Exercise for cardiac rehabilitation in a warming climate.

A Clinical Guide for Assessment and Prescription of Exercise and Physical Activity in Cardiac Rehabilitation. ACSANZ Position Statement.

Patients with cardiovascular disease benefit from cardiac rehabilitation, which includes structured exercise and physical activity as core components. This position statement provides pragmatic, evidence-based guidance for the assessment and prescription of exercise and physical activity for cardiac rehabilitation clinicians, recognising the latest international guidelines, scientific evidence and the increasing use of technology and virtual delivery methods. The patient-centred assessment and prescription of aerobic exercise, resistance exercise and physical activity have been addressed, including progression and safety considerations.

A scale for measuring home-based cardiac rehabilitation exercise adherence: a development and validation study

BackgroundThe benefits of home-based cardiac rehabilitation exercise are well-established and depend on long-term adherence. However, there is no uniform and recognized cardiac rehabilitation criterion to assess home-based cardiac rehabilitation exercise adherence for patients with cardiovascular disease. This study aimed to develop a home-based cardiac rehabilitation exercise adherence scale and to validate its psychometric properties among patients with chronic heart failure.MethodsThe dimensions and items of the scale were created based on grounded theory research, literature content analysis, and defined by a Delphi survey. Item analysis was completed to assess the discrimination and homogeneity of the scale. Factor analysis was adopted to explore and validate the underlying factor structure of the scale. Content validity and calibration validity were evaluated using the Delphi survey and correlation analysis, respectively. Reliability was evaluated by Cronbach’s α coefficients, split-half reliability coefficients, and test-retest reliability coefficients.ResultsA scale covering four dimensions and 20 items was developed for evaluating home-based cardiac rehabilitation exercise adherence. The content validity index of the scale was 0.986. In exploratory factor analysis, a four-factor structure model was confirmed, explaining 75.1% of the total variation. In confirmatory factor analysis, the four-factor structure was supported by the appropriate fitting indexes. Calibration validity of the scale was 0.726. In terms of reliability, the Cronbach’s α coefficient of the scale was 0.894, and the Cronbach’s α coefficients of dimensions ranged from 0.848 to 0.914. The split-half reliability coefficient of the scale was 0.695. The test-retest reliability coefficient of the scale was 0.745.ConclusionIn this study, a home-based cardiac rehabilitation exercise adherence scale was developed and its appropriate psychometric properties were confirmed.

Clinical Exercise Physiologists in Cardiac Rehabilitation and Clinical Exercise Testing

ABSTRACT Background The unique training of clinical exercise physiologists (CEPs) positions them to be an integral part of multidisciplinary teams in phase 2 cardiac rehabilitation (CR). However, the roles and responsibilities of CEPs vary widely between institutions. In addition, job tasks of CEPs at some institutions might not fully leverage their knowledge and skills. The purpose of this study was to describe the roles and responsibilities of CEPs working in CR and noninvasive clinical exercise testing at select institutions in the United States. Methods This was a descriptive study of the job tasks performed by CEPs in CR and noninvasive clinical exercise testing at select institutions. Job tasks that are common to CR and noninvasive clinical exercise testing were identified by a working group of the Clinical Exercise Physiology Association. Results The 6 CR programs in this report are predominately staffed by CEPs with no other health care professional present during exercise classes. In 5 of these programs CEPs perform all tasks required of phase 2 CR, from patient screening to program discharge. At 3 of the 4 programs that also performed noninvasive exercise testing, CEPs performed all the necessary tasks with no other health care professional present in the room during testing. Conclusion CEPs play an integral role in the conduct of phase 2 CR and noninvasive cardiology exercise testing. Granting privileges to CEPs that allow them to work at the top of their knowledge and skills will allow other health care professionals to better use their skills in other high demand areas.

Cardiac Rehabilitation in Coronary Artery Disease: Improving Outcomes and Adherence

Cardiac rehabilitation (CR) is a program that aims to improve the cardiovascular health of patients with coronary artery disease (CAD) through a multidisciplinary approach. CR typically includes exercise training, risk factor modification, psychosocial support, and education. Studies have shown that CR can improve exercise capacity, reduce angina symptoms, enhance overall quality of life, and reduce the risk of recurrent cardiovascular events. Despite the benefits of CR, adherence remains a challenge, and many patients with CAD do not participate in these programs. Strategies to improve adherence to CR include patient education, personalized goal setting, motivational interviewing, and peer support. Encouraging and supporting patients with CAD to participate in CR programs is crucial for the secondary prevention and long-term management of their condition. CR programs are typically supervised by healthcare professionals, such as cardiac rehabilitation specialists, exercise physiologists, and dietitians, who work together to develop personalized treatment plans for each patient. Exercise training is a key component of CR, and programs may involve aerobic and resistance training, as well as other forms of physical activity such as yoga or tai chi. Risk factor modification focuses on controlling blood pressure, reducing cholesterol levels, managing diabetes, and promoting smoking cessation. Psychosocial support and education may include counseling, stress management, and education on nutrition and medication management. While CR programs are effective, access to these programs may be limited for some patients, particularly those in underserved communities or rural areas. Tele-rehabilitation, which uses technology to provide remote delivery of CR services, has shown promise in increasing access to CR for patients who may not have access to traditional in-person programs. Overall, CR is a vital component of the management of CAD, and its benefits extend beyond cardiovascular health to include improvements in overall quality of life. It is important to raise awareness about the importance of CR and to work towards increasing access to these programs for all patients with CAD. J Medicine 2023; Vol. 34, No. 2(1) Supplement: 213

Does sedentary and physical activity behaviour change between exercise session days vs non exercise session days in patients attending a phase 3 cardiac rehabilitation program?

Abstract Funding Acknowledgements Type of funding sources: None. Background Physical activity (PA) is one of the main components of phase III cardiac rehabilitation (CR) programs. In people with coronary artery disease (CAD), higher levels of moderate to vigorous physical activity (MVPA) are associated with lower cardiovascular risk as well as lower levels of mortality. On the other hand, spending more time in sedentary behaviour is associated with lower levels of physical fitness and higher body mass index (BMI). According to the World Health Organization (WHO) recommendations, at least 150 minutes of MVPA should be performed per week (21.4 min/day) and sedentary behaviour should be reduced. CR programs tend to focus more on MVPA recommendations than sedentary behaviour, therefore more studies are needed to assess this behaviour. Purpose To analyse the levels of sedentary behaviour, light PA and MVPA of cardiovascular disease (CVD) patients attending a phase III CR program and compare those levels on exercise session days and non-exercise session days. Methods A total sample of 207 CVD patients were assessed when entering the CR phase III program. Physical activity was evaluated through accelerometery during seven consecutive days (including days of CR program exercise sessions and non-exercise sessions days). Demographic and clinical outcomes were retrieved, and BMI was calculated through weight in kilograms divided by the square of the height in meters. Independent-samples Mann-Whitney U test was used. Results One hundred and sixty-seven patients completed all the assessments (mean age 61 ± 10 years, 81.4% male, 87.4% CAD, BMI 28.17 ± 4.26 kg/m2). Results of PA were as follows: light PA (171 ± 49 minutes/day); MVPA (49 ± 32 minutes/day); percentage of time spent in sedentary behaviour (75.1 ± 7.2 %) and time in sedentary behaviour (11.0 ± 1.4 hours/day). Comparing CR exercise session days and non-session days, the analysis showed that light PA is significantly superior on exercise session days (177 ± 50 minutes/day vs 165 ± 48 minutes/day, p=0.027), as well as MVPA (60 ± 32 minutes/day vs 39 ± 29 minutes/day, p&amp;lt;0.001). Regarding the percentage of time spent in sedentary behaviour, it was found to be significantly higher on non-exercise session days (76.5 ± 7.0 % vs 73.7 ± 7.2 %, p&amp;lt;0.001). Conclusion These findings demonstrate that CVD patients attending a phase III CR program achieve the WHO recommendations for MVPA, especially on CR exercise session days, but sedentary behaviour is high in both exercise and non-exercise session days. This suggests that CVD patients should be instructed to adopt strategies that promote an increase in PA levels and a reduction in sedentary behaviour, especially on days when CR exercise sessions are not performed. An individualized PA counselling consult in CR programs, by specialized exercise professionals, might be a good strategy to improve PA and sedentary behaviour in CVD patients.